肝硬化患者肝性脑病的发生率与终末期肝病模型评分分析

目的评估肝硬化患者肝性脑病发生率与终末期肝病模型（MELD）评分的关系。方法对120例失代偿期肝硬化患者进行MELD评分，并观察患者肝眭脑病的发生情况。结果120例失代偿期肝硬化患者中发生肝性脑病53例，发生率为44．17％（53／120）。肝性脑病患者MELD评分为（21．69±9．22）分，非肝性脑病患者MELD评分为（9．32±4．63）分，两者比较差异有统计学意义（P〈0．05）。肝性脑病发生率随MELD评分的增高而增加（P〈0．01）。MELD评分预测患者发生肝性脑病的最佳临界值是14．13分（敏感度86．05％，特异度88．37％），MELD评分≥14．13分患者3个月内肝性脑病发生率显著高于MELD评分〈14．13分患者63．16％（48／76）比11．36％（5144）]，差异有统计学意义（χ2=30．32，P〈0．01）。结论MELD评分有助于预测失代偿期肝硬化患者肝性脑病的发生率。

Analysis the model for end-stage liver disease of hepatic encephalopathy in patients with cirrhosis

Objective To evaluate the relationship between the incidence rate of hepatic encephalopathy in patients with cirrhosis and the model for end-stage liver disease （MELD）. Methods The total of 120 patients with deeompensated cirrhosis were enrolled and followed-up. MELD score was obtained to observe the incidence of hepatic encephalopathy. Results The incidence of hepatic eneephalopathy was 44.17% （53/120）. ME LD score in hepatic encephalopathy patients was significantly higher than that in none hepatic encephalopathy patients （ 21.69 ± 9.22 ） scores vs. （9.32± 4.63 ） scores ], and there was significant difference （P 〈 0.05 ）. With the increase of MELD score, the incidence of hepatic encephalopathy increased （P 〈 0.01 ）. The best critical value of MELD score was 14.13 scores （the sensitivity of 86.05% and the specificity of 88.37% ）,when MELD ≥14.13 scores,the incidence of hepatic encephalopathy within 3 months was significantly higher 63.16%（48/76） vs. 11.36%（5/44 ） ] （χ2 = 30.32,P〈 0.01 ）. Conclusion MELD can help predicting the incidence of hepatic encephalopathy in deeompensated cirrhosis patients.